Acute Dementia After Deep Brain Stimulation in Parkinson Disease

Background: It is not clear whether cognitive adverse events can occur after subthalamic nuclei deep brain stimulation in Parkinson disease, and the putative mechanisms are poorly understood.

Case description: We report on a rare case of a 68-year-old woman with Parkinson disease but no previous cognitive impairment. The day after deep brain stimulation of the subthalamic nuclei, the woman presented with new-onset dementia and acute, severe, persistent, global cognitive decline, prompting a diagnosis of Alzheimer disease.

Conclusions: In patients seen in routine clinical practice, the simultaneous presence of several neurodegenerative diseases might not be uncommon. The assessment of mild cognitive impairment with a standardized method is highly recommended, a systematic 3-dimensional volumetric analysis of hippocampal structures should be part of the pre-deep brain stimulation evaluation, and cerebrospinal fluid biomarkers should be screened for if at least 1 of the 2 previously mentioned aspects is abnormal.